Radiation Therapy for Brain Metastases: ASCO Guideline Endorsement of ASTRO Guideline

David Schiff, Hans Messersmith*, Priscilla K. Brastianos, Paul D. Brown, Stuart Burri, Ian F. Dunn, Laurie E. Gaspar, Vinai Gondi, Justin T. Jordan, Julia Maues, Nimish Mohile, Navid Redjal, Glen H.J. Stevens, Erik P. Sulman, Martin Van Den Bent, H. James Wallace, Gelareh Zadeh, Michael A. Vogelbaum

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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PURPOSEAmerican Society of Radiation Oncology (ASTRO) has developed a guideline on appropriate radiation therapy for brain metastases. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.METHODS"Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline"2 was reviewed for developmental rigor by methodologists. An ASCO Endorsement Panel subsequently reviewed the content and the recommendations.RESULTSThe ASCO Endorsement Panel determined that the recommendations from the ASTRO guideline, published May 6, 2022, are clear, thorough, and based upon the most relevant scientific evidence. ASCO endorses "Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline."2RECOMMENDATIONSWithin the guideline, stereotactic radiosurgery (SRS) is recommended for patients with Eastern Cooperative Oncology Group performance status of 0-2 and up to four intact brain metastases, and conditionally recommended for patients with up to 10 intact brain metastases. The guideline provides detailed dosing and fractionation recommendations on the basis of the size of the metastases. For patients with resected brain metastases, radiation therapy (SRS or whole-brain radiation therapy [WBRT]) is recommended to improve intracranial disease control; if there are limited additional brain metastases, SRS is recommended over WBRT. For patients with favorable prognosis and brain metastases ineligible for surgery and/or SRS, WBRT is recommended with hippocampal avoidance where possible and the addition of memantine is recommended. For patients with brain metastases, limiting the single-fraction V12Gy to brain tissue to ≤ 10 cm3 is conditionally recommended.Additional information is available at www.asco.org/neurooncology-guidelines.

Original languageEnglish
Article numberJCO.22.00333
JournalJournal of Clinical Oncology
Publication statusPublished - 1 May 2022

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© American Society of Clinical Oncology.


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